Kindergarten Enrollment
This enrollment form is a shortened version to help the District identify students who are Kindergarten age. Students entering Kindergarten must be 5 years old by August 1st.  All students must reside in the Hermitage School District. Full registration and screening dates will be on April 12 and 13. Please email Mrs. Kobe at skobe@hermitage.k12.mo.us if you have any questions or call the elementary office at 417-745-6277.
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Child's Name *
Date of Birth (Month, Day, Year) *
Address *
City, State, Zip *
Sex *
Mother or Legal Guardian (Last, First, Middle) *
Phone Number (Home/Cell) *
Father or Legal Guardian (Last, First, Middle) *
Phone Number (Home/Cell) *
Parent Electronic Signature: I completed this form and I certify that the information above is accurate. I understand that providing false information for purposes of defrauding the government is punishable by law. (Please type full name below.) *
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